Chemo instead of radiotherapy cuts long-term side effects for children with brain tumours
Using chemotherapy to delay or avoid radiotherapy in children under three with a type of brain tumour called ependymoma reduces the risk of potentially damaging long term side effects, reveal trial results published online in the Lancet Oncology* today (Saturday).
Researchers from the Children's Cancer and Leukaemia Group (CCLG), funded by Cancer Research UK and Samantha Dickson Brain Tumour Trust, undertook a ten-year trial involving 89 children from the UK, Scandinavia and The Netherlands with newly diagnosed ependymomas, and monitored their progress for up to 12 years.
All of the children on the trial underwent surgery to try and remove their tumours followed by an intensive course of chemotherapy to kill off any remaining cancer cells.
Radiation treatment was reserved only for those children whose disease had spread or progressed. Of these patients, the chemotherapy treatment managed to delay their need for radiotherapy by more than one and a half years, so that the average age of children when they were given radiotherapy was 3.6 years, when their brains were more developed. This was opposed to the children being given radiotherapy as a first-line treatment as soon as they were diagnosed, often at a much younger age.
Around 350 children under the age of 15 are diagnosed with brain cancer each year in the UK. Around a tenth of these cases are ependymomas - equating to around 35 cases each year - half of which occur in children under the age of four. The researchers hope these results will benefit infants with other types of brain cancers.
Overall, 42 per cent of the patients did not receive any radiation treatment for their cancer and almost two-thirds of the children - 64 per cent - were still alive five years after diagnosis. The three-year survival rate for children on the trial is equal to the best published radiotherapy results and the five-year survival rate is better than previous trials that have used radiotherapy as a matter of course.
Study author Professor Richard Grundy from the Children's Brain Tumour Research Centre at the Queen's Medical Centre, University of Nottingham said: "It's clear from this study that a significant proportion of children can be spared, or have delayed, the effects of radiotherapy by using chemotherapy.
"We know radiotherapy can be harmful to the developing brain, so avoiding it or using it at an older age if needed will hopefully reduce any learning difficulties these children may develop as a result of this treatment without compromising their chance of a cure."
The purpose of this trial was to see if doctors could spare children radiotherapy by using chemotherapy instead. The majority of long term survivors who are treated with radiotherapy for ependymomas experience reduced IQ and short term memory loss.
Kate Law, director of clinical trials at Cancer Research UK, said: "This study provides exciting results for young children with ependymomas. This improvement in quality of life could be significant and we hope children diagnosed with this and other types of brain cancer in the future will benefit from these findings.
"As more children survive cancer, we welcome any research that adds to our understanding of how to reduce the long-term side effects of treatment."
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Notes to Editor
- "A prospective trial of primary post-operative chemotherapy without radiotherapy for intracranial ependymoma in children under 3 years of age a UKCCSG/SIOP study" RG Grundy et al. (2007) Lancet Oncology.
- This study was coordinated by the Children's Cancer and Leukaemia Group through support from Cancer Research UK and the Samantha Dickson Brain Tumour Trust.
The Children's Cancer and Leukaemia Group
Cancer Research UK is the major supporter of the Children's Cancer and Leukaemia Group (formally the UK Children's Cancer Study Group) and funds the UK clinical trials work of the group via its coordinating centre in Leicester and 22 paediatric centres throughout the British Isles.
The Children's Cancer and Leukaemia Group is the national professional body responsible for the organisation, treatment and management of virtually all children with cancer in the UK. The group is acknowledged as one of the world's leading childhood cancer clinical trial groups and over the past five years there has been significant progress and success in its trials, resulting in improvements in survival.
Cancer Research UK is the largest supporter of research into children's cancer in the UK. The charity is committed to improving survival and quality of life for every child with cancer.
Samantha Dickson Brain Tumour Trust
The Trust is the largest dedicated brain tumour charity in the UK as well as being the most significant funder of laboratory-based brain tumour research in this country. Set up 10 years ago by founding Trustees, Neil and Angela Dickson in memory of their daughter Samantha, the Trust has gone from strength to strength, raising nearly £5 million for research and patient support.
Over ten years the Charity has funded 43 high quality research projects all of which have been extensively peer-reviewed, resulting in a number of published papers. In addition over 3,000 patients and carers have been supported.
Cancer Research UK
- Together with its partners and supporters, Cancer Research UK's vision is to beat cancer.
- Cancer Research UK carries out world-class research to improve understanding of the disease and find out how to prevent, diagnose and treat different kinds of cancer.
- Cancer Research UK ensures that its findings are used to improve the lives of all cancer patients.
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